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Posttraumatic Stress DisorderNCT06185244

Efficacy of Internet-delivered Trauma-focused CBT for Young People With PTSD

A study testing Therapist-supported internet-delivered trauma-focused CBT and 12 weeks of therapist-supported internet-delivered psychoeducation and stress management/relaxation for both the youth and the care giver. in people with Posttraumatic Stress Disorder, run by Karolinska Institutet at 1 site in Sweden.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to compare therapist-guided internet delivered trauma-focused cognitive behavior therapy (CBT) to an active control condition comprising therapist-guided internet delivered cognitive behavioral therapy containing relaxation techniques and psychoeducation for young people with… Read more about this study

Who is it for?
Ages 13 to 17 years
Conditions the study is for
Posttraumatic Stress Disorder
What is being tested?
Therapist-supported internet-delivered trauma-focused CBT and 12 weeks of therapist-supported internet-delivered psychoeducation and stress management/relaxation for both the youth and the care giver.
Could I receive a placebo?
No, everyone receives an active treatment
How many people
240 participants
Where
1 siteSweden
Study dates
11 Mar 2024to 4 Jan 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 13 to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • 13-17 years,
  • Primary PTSD diagnosis
  • Fluent in Swedish
  • Access to the Internet at home or can use vouchers for internet-access to their phone.
  • Parent/guardian willing and able to take part in treatment.

Who cannot join

  • PTSD is not the primary concern
  • Initiation or adjustment of any psychotropic medication within the last 4 weeks prior to commencement of treatment
  • Serious mental health symptoms, such as mania, psychosis, alcohol, or substance use disorders or current suicide risk warranting immediate clinical attention.
  • Ongoing trauma-focused CBT or Eye movement desensitization and reprocessing Therapy
  • Ongoing trauma-related threat

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Erica Mattelin contact

erica.mattelin@rb.se

Sweden1 site, 1 recruiting
  • Barn och ungdomspsykiatrin, BUP Internetenhet and Save the Children

    Stockholm

    Maria Bragesjö, PhD

    Recruiting

Other trials in Sweden

About this study

Official title: Efficacy and Cost Effectiveness of Internet-delivered Trauma-focused CBT for Young People With PTSD

The goal of this clinical trial is to compare therapist-guided internet delivered trauma-focused cognitive behavior therapy (CBT) to an active control condition comprising therapist-guided internet delivered cognitive behavioral therapy containing relaxation techniques and psychoeducation for young people with post-traumatic stress disorder regarding efficacy and cost effectiveness.

Young people with post-traumatic stress disorder will be randomly assigned to receive either 12 weeks of therapist-guided internet delivered trauma-focused cognitive behavior therapy (iTF-CBT) or therapist-guided internet delivered cognitive-behavioral therapy containing relaxation and psychoeducation.

Read the detailed description

There is an urgent need for evidence-based treatments for children with PTSD that can easily be made available to a large number of afflicted. The overall aim of the project is to increase the availability of evidence-based psychological treatments for adolescents with PTSD by developing and evaluating iTF-CBT for this target group. The main objectives are to establish the efficacy, cost-effectiveness, and long-term effects of iTF-CBT for adolescents with PTSD in an RCT (N=140) by comparing guided iTF-CBT with an attention control group consisting of therapist-supported internet-delivered psychoeducation and support.

The study is a single-blind, parallel-group superiority randomized controlled trial with 240 patients (120 per arm) that will compare therapist-guided internet delivered trauma-focused cognitive behavior CBT with therapist-guided internet delivered cognitive-behavioral therapy comprising relaxation and psychoeducation. The primary outcome is the blind-rater administered Clinician-Administered PTSD Scale for DSM-5 (CAPS-5-CA). An internal pilot is built in in the design and the first 20 enrolled participants will not be randomized but receive the active intervention. They will also be asked to participate in qualitative interviews about their experience of the intervention.

Secondary outcomes are cost effectiveness, predictors of clinically meaningful change in symptoms, mediators of change, dropout rate, and negative effects.

Research questions:

  1. Is guided iTF-CBT more efficacious than an active control condition (therapist-supported internet-delivered psychoeducation and support) in regard to reduction of blinded assessor rated PTSD symptom severity 1-month post-treatment?
  2. Is guided iTF-CBT more cost-effective than an active control condition (therapist-supported internet-delivered psychoeducation and support) in regard to reduction of blinded assessor rated PTSD symptom severity 1-month post-treatment?
  3. Are the therapeutic gains of iTF-CBT maintained at long term follow up (6 and 12 months after treatment)?
  4. How do children, parents and therapists perceive iTF-CBT?
Being tested
Therapist-supported internet-delivered trauma-focused CBT, 12 weeks of therapist-supported internet-delivered psychoeducation and stress management/relaxation for both the youth and the care giver.
Keywords
PTSD, digital treatment, trauma-focused CBT, therapist-guided
Medical subject headings
Stress Disorders, Post-Traumatic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Therapist-supported internet-delivered trauma-focused CBTBehavioural

    12 weeks of therapist-supported internet-delivered trauma-focused CBT for both the youth and the care giver.

  • 12 weeks of therapist-supported internet-delivered psychoeducation and stress management/relaxation for both the youth and the care giver.Behavioural

    12 weeks of therapist-supported internet-delivered psychoeducation and stress management/relaxation for both the youth and the care giver.

Study groups in NCT06185244
Study groupRoleWhat they receive
Therapist-supported internet delivered trauma-focused CBTExperimentalTherapist-supported internet delivered trauma-focused CBT. The protocol mirrors the exact content of first-line treatment for children with PTSD but is delivered through a digital platform and will comprise of text-based material as well as audio files and video illustrations in an age-appropriate manner that the participant gains access to sequentially. iTF-CBT will be therapist-assisted, and each participant will have a designated therapist to guide them through treatment. Treatment will span over 12 weeks and integrates cognitive, behavioral, interpersonal, and family therapy principles as well as trauma interventions. Parallel to the child's treatment, the caregivers are provided the same components and parenting practices, and joint child-parent activities are included. Participants will have access to a therapist that will guide them through treatment in a text based format.
Receives: Behavioral: Therapist-supported internet-delivered trauma-focused CBT
Therapist-supported psychoeducation and stress managementActive comparatorTherapist-supported CBT internet-delivered treatment comprising psychoeducation about PTSD, relaxation/stress management techniques and relapse prevention. The treatment will be delivered in a digital platform for twelve weeks. Participants will have access to a therapist that will guide them through treatment in a text-based material as well as audio files and video illustrations in an age-appropriate manner that the participant gains access to sequentially.
Receives: Behavioral: 12 weeks of therapist-supported internet-delivered psychoeducation and stress management/relaxation for both the youth and the care giver.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in PTSD symptoms as assessed by the Clinician Administered PTSD Scale Children and Adolescent version 5 (CAPS-5-CA)

    The CAPS-5-CA is a structured interview that assesses the Diagnostic and Statistical Manual of Mental Disorders version 5 (DSM-5) criteria for PTSD (Weathers et al., 2013). Each item is rated on a severity scale ranging from 0 (Absent) to 4 (Extreme/incapacitating) and combines information about frequency and intensity for each of the 20 symptoms. Total Score (Range 0-80 with higher scores representing more PTSD symptoms.

    Measured: Baseline, 1-month (primary endpoint), 6-month and 12-month after treatment completion

Secondary outcomes (14)
  1. Change in self-rated symptoms of PTSD and complex PTSD measured by The Child and Adolescent Trauma Screen (CATS-2)

    The CATS-2 measures potentially traumatic events (PTEs), posttraumatic stress symptoms (PTSS) and impairment according to DSM-5 and ICD-11 criteria in children and adolescent from 7 to 17 years. In addition to a self-report measure for children and adolescents, the CATS-2 includes a parallel caregiver version. Posttraumatic stress symptoms in the last four weeks are then assessed using 25 items rated on a 4-point. The 25 items map directly onto the diagnostic criteria for PTSD in DSM-5 and ICD-11 PTSD and CPTSD. The DSM-5 PTSD severity score is the sum of items 1-20 (range 0-60), including only the highest score of items 9, 10, 15. The ICD-11 PTSD severity score (range 0-18) is the sum of items 2, 3, 6, 7, 17, 18. The ICD-11 CPTSD score (range 0-36) is the sum of ICD-11 PTSD severity score (2, 3, 6, 7, 17, 18) plus the sum of the ICD-11 DSO severity score (9b, 9d, 10a, 13, 14, 15a). Higher scores represents more PTSD symptoms.

    Measured: Baseline, through the treatment period up to 12 weeks and 1-month, 6-month and 12-month after treatment completion

  2. Change in self-rated symptoms of depression as measured by Mood and Feelings Questionnaire (MFQ)

    The MFQ consists of a series of 33 descriptive phrases regarding how the subject has been feeling or acting recently. Respondents are asked whether descriptions in the questionnaire are 'true', 'sometimes true' or 'not true' for them over the past two weeks. The MFQ is scored by summing together the point values of responses for each item. The response choices and their designated point values are as follows: "not true" = 0 points, "sometimes true" = 1 point, "true" = 2 points. Higher scores on the MFQ suggest more severe depressive symptoms.

    Measured: Baseline, immediately after treatment completion, and 1-month, 6-month and 12-month after treatment completion

  3. Change in psychosocial impairment measured by The Education, Work and Social Adjustment Scale, Youth and Parent (EWSAS)

    EWSAS is a short, self-reported instrument consisting of five items about psychosocial impairments rated on a nine-point Likert scale. A higher score means more severe impairment.

    Measured: Baseline, immediately after treatment completion, and 1-month, 6-month and 12-month after treatment completion

  4. Change in Treatment Inventory of Costs in Psychiatric Patients (TIC-P)

    Self-rated questionnaire on healthcare utilization and productivity losses in patients with a psychiatric disorder. The TIC-P questionnaire measures costs in two dimensions: use of health resources and loss of productivity. Lower cost is better.

    Measured: Baseline, immediately after treatment completion, and 1-month, 6-month and 12-month after treatment completion

  5. Adverse events related to treatment measured by the Negative effects questionnaire

    Self-rated questionnaire on negative effects. It contains 32 items that are scored on a five point Likert-scale (0-4) and differentiates between negative effects that are attributed to treatment and those possibly caused by other circumstances. The total score of the NEQ ranges from 0 to 80 points, a higher score reflects more negative effects.

    Measured: Immediately after treatment completion, 1-month, 6-month and 12-month after treatment completion

  6. Quality of life measured by Assessment of Quality of Life KIDSCREEN-10

    Change in subjective psychological, mental and social well-being from baseline to immediately after treatment and follow up . a higher score reflects higher health-related quality of life.

    Measured: Immediately after treatment completion, 1-month, 6-month and 12-month after treatment completion

  7. Participants satisfaction with treatment, assessed by The Client Satisfaction Questionnaire (CSQ-8).

    The CSQ-8 yields a single score measuring a single dimension of overall satisfaction. An "overall score" is calculated by summing the score on each of the eight scale item. Scores range from 8 to 32, with higher values indicating higher satisfaction.

    Measured: Immediately after treatment completion.

  8. Number of completed treatment modules

    Data will be gathered on total number of completed modules during the 12 week treatment.

    Measured: Baseline up to 12 weeks

  9. Number of messages sent and received in the digital platform

    Data will be gathered on total number of messages sent and received back and forth between the participant and the therapist during the 12 week treatment.

    Measured: Baseline up to 12 weeks

  10. Number of home work assignments made by the participant during the treatment period

    umber of home work assignments made by the participant during the treatment period

    Measured: up to 12 weeks

  11. The proportion of participants that conducts the weekly measures and further assessment points

    The proportion of participants that conducts the weekly measures and further assessment points

    Measured: up to the 6 months follow up

  12. The proportion of participants that go through the entire treatment period

    The proportion of participants that go through the entire treatment period

    Measured: up to 12 weeks

  13. Number of drop-outs from treatment

    Number of drop-outs from treatment

    Measured: up to 12 weeks

  14. Participants experience/satisfaction with treatment and assessment procedures through qualitative interviews

    Participants experience/satisfaction with treatment and assessment procedures through qualitative interviews

    Measured: up to the 6-month follow up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Dec 2023
  2. Study start11 Mar 2024
  3. Primary completion4 Jan 2027 (estimated)
  4. Study completion4 Jan 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized controlled trial
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
240 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06185244
Sponsor's protocol ID
2023-06501-01
Other IDs
2023
Status last verified
Mar 2024
First submitted
14 Dec 2023
Last updated
13 Mar 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Mattelin E, Weyler H, Andersson R, Paulsen J, Tielman S, Vikgren A, Bondjers K, Serlachius E, Mataix-Cols D, Bragesjo M. Feasibility and acceptability of therapist-guided, asynchronous, internet-delivered trauma-focused CBT for adolescents with PTSD: a single-group feasibility trial in Sweden. BMJ Open. 2026 May 27;16(5):e117024. doi: 10.1136/bmjopen-2026-117024.

    PubMed 42203279

Questions about this trial

What is this clinical trial studying?

A study testing Therapist-supported internet-delivered trauma-focused CBT and 12 weeks of therapist-supported internet-delivered psychoeducation and stress management/relaxation for both the youth and the care giver. in people with Posttraumatic Stress Disorder, run by Karolinska Institutet at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 13 Mar 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Maria Bragesjö (+46(0)703399387, maria.bragesjo@ki.se), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in PTSD symptoms as assessed by the Clinician Administered PTSD Scale Children and Adolescent version 5 (CAPS-5-CA) (time frame: Baseline, 1-month (primary endpoint), 6-month and 12-month after treatment completion). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06185244, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Mar 2024.

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